CMS Withdraws Medicaid Cell, Gene Therapy Price ‘Verification’ Survey Plan

The move is positive for manufacturers and follows the agency’s decision to drop another contentious proposal that would have ‘stacked’ drug discounts when calculating Medicaid best prices.

The Audit Plan Would Have Exceeded Agency Authority, Critics Said. • Source: Shutterstock

The US Centers for Medicare and Medicaid Services will not impose a plan requiring wholesalers and manufacturers of selected high-cost drugs, including cell and gene therapies, to disclose how prices are set for Medicaid, a recently-released final rule on various Medicaid drug rebate program issues states.

Key Takeaways
  • A controversial CMS proposal to audit manufacturers about how they set the price of selected cell and gene therapies in Medicaid to pave the way for price concessions was withdrawn in a recently-issued final rule

While CMS did not finalize the policy, it said comments may inform future

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